Occupationally Acquired Plasmodium knowlesi Malaria in Brunei Darussalam

Simian malaria is a zoonotic disease caused by Plasmodium knowlesi infection. The common natural reservoir of the parasite is the macaque monkey and the vector is the Anopheles mosquito. Human cases of P. knowlesi infection has been reported in all South East Asian countries in the last decade, and it is currently the most common type of malaria seen in Malaysia and Brunei. Between 2007–2017, 73 cases of P. knowlesi infection were notified and confirmed to the Ministry of Health in Brunei. Of these, 15 cases (21%) were documented as work-related, and 28 other cases (38%) were classified as probably related to work (due to incomplete history). The occupations of those with probable and confirmed work related infections were border patrol officers, Armed Forces and security personnel, Department of Forestry officers, boatmen and researchers. The remaining cases classified as most likely not related to work were possibly acquired via peri-domestic transmission. The risk of this zoonotic infection extends to tourists and overseas visitors who have to travel to the jungle in the course of their work. It can be minimised with the recommended use of prophylaxis for those going on duty into the jungles, application of mosquito/insect repellants, and use of repellant impregnated uniforms and bed nets in jungle camp sites.

Brunei Publications in the Science Citation Index Expanded (1973-2016): Bibliometrics and comparison with other tropical countries / Publicaciones de Brunei en el Science Citation Index Expanded (1973-2016): Bibliometría y comparación con otros países tropicales

Abstract Brunei is a small tropical country -located in Southeast Asia- for which there are no previous bibliometric studies. Here we analyze papers published by Brunei scientists from 1973 to 2016 in the Science Citation Index Expanded and compare results with other tropical countries. We identified 1 547 publications and 11 document types. The most productive categories were ecology, multidisciplinary geosciences, inorganic and nuclear chemistry, and environmental sciences. Singapore Medical Journal published most of these papers, and the three most productive institutions were Universiti Brunei Darussalam, RIPAS Hospital, and Universiti Teknologi Brunei. UK and Malaysia were the most frequent collaborating countries. M.A. Ali from the Universiti Brunei Darussalam was the most prolific author and a Brunei independent article written by C.K. Morley from the Universiti Brunei Darussalam in 2002 had the highest number of citations of the whole period and the highest number in 2016. The tropical countries of Central America and Asia have a few similarities but also important differences, and both are highly heterogeneous in scientific organization and productivity. Rev. Biol. Trop. 66(3): 1090-1100. Epub 2018 September 01.

Resumen Brunei es un pequeño país tropical del sudeste asiático, sobre el cual no hay estudios bibliométricos. Aquí analizamos los artículos publicados por científicos de Brunei de 1973 a 2016 y comparamos los resultados con otros países tropicales. Examinamos los documentos del Science Citation Index Expanded en la colección principal del Web of Science. Hallamos 1 547 publicaciones de Brunei con 11 tipos de documentos, donde las categorías más productivas fueron ecología, geociencias multidisciplinarias, química inorgánica y nuclear, y ciencias ambientales. Singapore Medical Journal publicó la mayoría, y las tres instituciones más productivas fueron: Universiti Brunei Darussalam, RIPAS Hospital y Universiti Teknologi Brunei. Reino Unido y Malasia fueron los países que más colaboraron con Brunei. M.A. Ali de la Universidad Brunei Darussalam fue el autor más prolífico. El mayor número total de citas, y el mayor número de citas en 2016, correspondieron a un artículo exclusivamente de Brunei, escrito por C. K. Morley de la Universiti Brunei Darussalam en 2002. Los países tropicales de América Central y Asia tienen algunas similitudes pero también diferencias importantes, siendo heterogéneos en su organización científica y productividad.

Stroke Epidemiology in South, East, and South-East Asia: A Review / 대한뇌졸중학회지

Asia, which holds 60% of the world’s population, comprises some developing countries which are in economic transition. This paper reviews the epidemiology of stroke in South, East and South-East Asia. Data on the epidemiology of stroke in South, East, and South-East Asia were derived from the Global Burden of Disease study (mortality, disability-adjusted life-years [DALYs] lost because of stroke), World Health Organization (vascular risk factors in the community), and publications in PubMed (incidence, prevalence, subtypes, vascular risk factors among hospitalized stroke patients). Age- and sex-standardized mortality is the lowest in Japan, and highest in Mongolia. Community-based incidence data of only a few countries are available, with the lowest rates being observed in Malaysia, and the highest in Japan and Taiwan. The availability of prevalence data is higher than incidence data, but different study methods were used for case-finding, with different age bands. For DALYs, Japan has the lowest rates, and Mongolia the highest. For community, a high prevalence of hypertension is seen in Mongolia and Pakistan; diabetes mellitus in Papua New Guinea, Pakistan, and Mongolia; hypercholesterolemia in Japan, Singapore, and Brunei; inactivity in Malaysia; obesity in Brunei, Papua New Guinea, and Mongolia; tobacco smoking in Indonesia. Hypertension is the most frequent risk factor, followed by diabetes mellitus and smoking. Ischemic stroke occurs more frequently than hemorrhagic stroke, and subarachnoid hemorrhages are uncommon. There are variations in the stroke epidemiology between countries in South, East, and South-East Asia. Further research on stroke burden is required.

Psychosocial Work Stressors, Work Fatigue, and Musculoskeletal Disorders: Comparison between Emergency and Critical Care Nurses in Brunei Public Hospitals

PURPOSE: Little evidence estimated the exposure of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders for nurses working in South-East Asian region, and research on this subject is almost nonexistent in Brunei. The main aim of our study was to provide a comprehensive exploration and estimate exposure of the study variables amongst emergency (ER) and critical care (CC) nurses in Brunei. The study also aims to compare whether experiences of ER nurses differ from those of CC nurses. METHODS: This cross-sectional study was implemented in the ER and CC departments across Brunei public hospitals from February to April 2016 by using Copenhagen Psychosocial Questionnaire II, Occupational Fatigue Exhaustion Recovery scale, and Cornell Musculoskeletal Discomfort Questionnaire. RESULTS: In total, 201 ER and CC nurses (82.0% response rate) participated in the study. Quantitative demands of CC nurses were significantly higher than ER nurses. Even so, ER nurses were 4.0 times more likely [95% confidence interval (2.21, 7.35)] to experience threats of violence, and 2.8 times more likely [95% confidence interval: (1.50, 5.29)] to experience chronic fatigue. The results revealed that nurses experienced high quantitative demands, work pace, stress, and burnout. High prevalence of chronic and persistent fatigue, threats of violence and bullying, and musculoskeletal pain at the neck, shoulder, upper and lower back, and foot region, was also reported. CONCLUSION: This study has provided good estimates for the exposure rate of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders among nurses in Brunei. It provided important initial insight for nursing management and policymakers to make informed decisions on current and future planning to provide nurses with a conducive work environment.

Humanitarian Assistance and Disaster Relief mission by a tripartite medical team led by the Singapore Armed Forces after the 2015 Nepal earthquake

<p><b>INTRODUCTION</b>This study aimed to report the injury or disease patterns, challenges, key observations, and recommendations by the Singapore Armed Forces (SAF) team that embarked on an Humanitarian Assistance and Disaster Relief (HADR) mission in the aftermath of the April 2015 Nepal earthquake.</p><p><b>METHODS</b>The SAF medical team that provided HADR assistance to Nepal consisted of personnel from the SAF, Singapore¢s Ministry of Health and the Royal Brunei Armed Forces. Upon arrival in Kathmandu, Nepal, the SAF medical team was assigned to the Gokarna district by the local health authorities. In addition to providing primary healthcare, the medical facility was equipped to perform resuscitation and minor procedures. We also assembled mobile medical teams (MMTs) that travelled to various remote areas of the country to deliver medical aid.</p><p><b>RESULTS</b>A total of 3,014 patients were managed by the SAF medical team. Of these patients, 1,286 (42.7%) were men. 574 (19.0%) patients sustained earthquake-related injuries or illnesses, while 2,440 (81.0%) sustained non-earthquake-related injuries or illnesses. The team treated a total of 447 (77.9%) adults and 127 (22.1%) paediatric patients with earthquake-related injuries or illnesses. A significant number of patients developed exacerbations of underlying medical conditions. 2,161 (71.7%) patients were treated in our main facility in Gokarna, while 853 patients (28.3%) were treated by our MMTs.</p><p><b>CONCLUSION</b>The ability to transport healthcare personnel and essential medical equipment within a short time allowed the SAF medical team to provide crucial medical care in the aftermath of the 2015 Nepal earthquake.</p>

First detection of chikungunya infection and transmission in Brunei Darussalam

This report describes the chikungunya cases and local transmission detected in Brunei Darussalam for the first time, despite the country being situated in a region that has experienced a multitude of outbreaks over the years. A combined strategy of active case detection, patient isolation and vector control measures was deployed in an attempt to avert further transmission. The findings have important public health implications for international surveillance and control strategies for this re-emerging disease.

Cervical cancer in Brunei Darussalam

<p><b>INTRODUCTION</b>Cervical cancer caused by the human papilloma virus (HPV) is a common cancer in women. There is no published data on the recent incidence of cervical dysplasia, cervical cancer and genital warts caused by the different types of HPVs in Brunei Darussalam.</p><p><b>METHODS</b>A cross-sectional, retrospective study was conducted utilising data from patients diagnosed with cervical cancer during the period 2005-2009 in Brunei Darussalam. The varying incidences of different types of cervical lesions among various ethnic and age groups, and in the overall population, were determined.</p><p><b>RESULTS</b>The mean age-standardised incidence of invasive cervical cancer during the five-year period was 24.9 per 100,000 women per year (95% confidence interval [CI] 21.7, 28.1). Age-specific invasive cervical cancer incidence peaked in the age group 45-59 years. Chinese females tended to have a higher incidence of invasive cervical cancer (28.2 per 100,000 women per year; 95% CI 17.8, 38.7) than Malay females (20.6 per 100,000 women per year; 95% CI 17.1, 24.2), while other ethnic groups in Brunei Darussalam had a significantly lower incidence (6.5 per 100,000 women per year; 95% CI 3.0, 10.0).</p><p><b>CONCLUSION</b>The results suggest that Brunei Darussalam has a relatively higher incidence of cervical cancer compared to its neighbouring countries. The findings support the need for more comprehensive screening, public education programmes and vaccination against HPV in the country.</p>

Sequence analysis of E/NS1 gene junction of dengue virus type 2 isolated in Brunei.

A preliminary study of dengue infection in Brunei between 2005 and 2006 showed that dengue 2 was the predominant serotype. A total of five DEN-2 isolates were isolated and maintained in the mosquito cell-line, albopictus C6/36. The sequence spanning the envelope and non-structural protein 1 (E/NS1) junction (positions 2311 to 2550) of the isolates were determined and analysed at the amino acid and nucleotide levels. Alignment of the 240 nucleotide sequences among the five isolates showed changes occurring at 7 positions (2.9%) of the region. All but one nucleotide substitution (position 2319, amino acid 742 V --> F) were found at the 3rd position of the codons and were silent mutations. Amino acid homology ranged from 98% to 100%. Sequence divergence of the Brunei isolates varied from 5% to 6.6% compared with dengue-2 prototype New Guinea C strain. Comparison of the Brunei DEN-2 isolates with sixty-five other strains placed them in a cluster containing Indonesian strains isolated in 1973, 1978 and 2004 and Malaysian strains isolated in 1996, 1998 and 1999 in genotype group IV.

Prevalence of hepatitis-B surface antigen in the pregnant women of Brunei Darussalam.

In view of the high incidence of mother-to-child transmission of hepatitis B virus (HBV), routine screening of pregnant at antenatal clinic and vaccination of the newborn has become a common practice throughout the world. The prevalence of HBsAg in pregnant women of Brunei Darussalam was assessed. Of 1,267 pregnant women who attended the antenatal clinic of Suri Seri Begawan Hospital, Kuala Belait, the overall prevalence of HBsAg was 3.2% with significant differences in various ethnic groups (p less than 0.05). Malays, who form the major ethnic group had the lowest rate of 1.9%.

Salmonella isolation experience in the Pacific Basin region: a survey.

To determine if the unusually high incidence of salmonellosis reported on Guam for several years might be the result of more frequent bacteriologic examination of gastroenteritis/diarrhoea patient stool specimens, a survey of medical clinic and laboratory activities was undertaken among countries in the Pacific Basin Area. Survey results suggest that while Guam laboratories may be particularly proficient in isolating Salmonella organisms, the quantity of stool specimens examined could not account for the higher incidence of salmonellosis observed on the island.

A coxsackievirus type A24 epidemic conjunctivitis in Brunei.

The paper reports on a coxsackievirus type A24 epidemic of acute conjunctivitis in Brunei. The role of the Singapore Epidemic Conjunctivitis 1970 (coxsackievirus type A24) virus in the new disease syndrome variously known as the "Epidemic Haemorrhagic Conjunctivitis", "Picornavirus Epidemic Conjunctivitis" and "Acute Haemorrhagic Conjunctivitis" is again established.